What should I do if I become drug-resistant after taking Venetoclax?

Venetoclax (Venetoclax) shows significant activity in hematological malignancies, such as chronic lymphocytic leukemia or small lymphocytic lymphoma, acute myeloid leukemia, etc. The occurrence and development of malignant tumors often involve multiple signaling pathways. Hematologic malignancies often develop acquired or intrinsic resistance to venetoclax. Due to various reasons, the most common mechanism of venetoclax resistance is the overexpression of anti-apoptotic proteins of the BCL2 family, such as BCL-XL.

Malignant cells replace BCL-2 by up-regulating the expression of non-BCL-2 anti-apoptotic proteins in the BCL-2 family and continue to bind to BIM proteins, thereby directly antagonizing the effects of venetoclax. Combination regimens based on venetoclax are important treatment options for the treatment of hematological malignancies. Combining low-dose BCL-XL and BCL-W inhibitors (such as navitoclax) with venetoclax may be effective and prevent cells from developing resistance to venetoclax without dose-limiting thrombocytopenia.

The original drug of Venacla is already on the market in China, and can be found in the Category B medical insurance directory. The specification is 100mg*14 tablets and the price per box may be around RMB 5,000. The Turkish version of Venaclaoriginal drug, specifications100mg*112 tablets, sold overseas, costs around RMB 10,000 per box (the price may fluctuate due to exchange rates), which is even more expensive. Cheaper generic drugs are also sold overseas, and their pharmaceutical ingredients are basically the same as those of the original drugs. The price of a box of 100mg*120 tablets produced by a Bangladeshi pharmaceutical factory is around RMB 4,000 (prices may fluctuate due to exchange rates).